Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 2014-00644 | NC |
NPI | 1073774964 |
---|---|
Provider Name | Shannon N Chadha |
First Address | Charlotte, NC 28263-3376 |
Second Address | Charlotte, NC 28204-4375 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2008 |
Last Update Date | 26/10/2016 |